Commonly assigned U.S. application Ser. No. 13/354,100 filed Jan. 19, 2012 by the same inventors, the disclosure which is hereby incorporated by reference in its entirety, discloses a system and method of diagnosing acid reflux using an involuntary reflex cough test. In one example as disclosed, a nasogastric/orogastric (Ng/Og) device is inserted into the stomach and the involuntary reflex cough epoch induced. The intra-abdominal pressure and elevational reflux along the Ng/Og device is measured. In an example, the functional status of the gastric valve is determined based on the measured intra-abdominal pressure and elevational reflux along the catheter. This is a limited analysis that is not always accurate to determine whether there is a reflux problem, requiring an Ng/Og device, which in some cases can interfere with the gastric valve and the lower esophageal sphincter. In another example, an Ng/Og device with an esophageal cuff is used with a sequence of steps, such as inflating a cuff, inducing the involuntary reflex cough epoch, determining if acid reflux has occurred, deflating the esophageal cuff, and again inducing the involuntary reflex cough epoch. Results can be used to determine the functional status of the gastric valve. This is a limited type of test that has not always been found advantageous.
Use of the involuntary reflex cough test with or without a voluntary cough test is also disclosed in commonly assigned U.S. patent application Ser. No. 11/608,316 filed Dec. 8, 2006; Ser. No. 11/550,125 filed Oct. 17, 2006; Ser. No. 12/643,134 filed Dec. 21, 2009; Ser. No. 12/643,251 filed Dec. 21, 2009; Ser. No. 12/878,257 filed Sep. 9, 2010; Ser. No. 12/878,281 filed Sep. 9, 2010; and Ser. No. 12/878,316 filed Sep. 9, 2010; the disclosures which are all hereby incorporated by reference in their entirety. The '257, '281 and '316 applications disclose oral-esophageal-gastric devices, some with esophageal cuffs and/or reflux measurement systems that can be used to assess GERD or determine stress urinary incontinence in some examples using the involuntary reflex cough tests alone or in combination with the voluntary cough test.
In one current test used to determine gastric reflux, fluoroscopy is used. A clinician or doctor will conduct a radiology sweep and use fluoroscopy, also termed video fluoroscopy. A patient swallows a barium drink, for example, containing barium sulphate, typically about 500 to about 1,000 milliliters. The patient lays on a table and the pictures are taken. Often, a tablet or drink is ingested, also termed a fizzy, to produce gas, which acts similar to Alka-Seltzer. Thus, the barium and gas exists in the stomach. Often the patient will lay on their left or right side or the clinician will tilt the patient over such that the head is down. At this point, it is possible to determine if there is acid reflux (or stomach back-up into the esophagus) by viewing the barium. In that respect, the clinician is testing the gastric valve, but the clinician also often claims they are also testing the lower esophageal sphincter (LES). Practitioners have found that test confusing and note reliable indicators are required to determine competency of the gastric valve relative to the lower esophageal sphincter (LES).